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Validation of a brief cross-cultural cognitive screening test in Multiple Sclerosis

  • Alfonso Delgado-Álvarez
    Affiliations
    Department of Neurology, Hospital Clinico San Carlos, San Carlos Institute for Health Research (IdiSSC), Universidad Complutense, Profesor Martin Lagos St. ES-28040, Madrid, Spain

    Faculty of Psychology, Universidad Autónoma de Madrid, Madrid, Spain
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  • Cristina Delgado-Alonso
    Affiliations
    Department of Neurology, Hospital Clinico San Carlos, San Carlos Institute for Health Research (IdiSSC), Universidad Complutense, Profesor Martin Lagos St. ES-28040, Madrid, Spain
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  • Miriam Goudsmit
    Affiliations
    Department of Psychiatry and Medical Psychology, OLVG Hospital, Amsterdam, the Netherlands
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  • María José Gil
    Affiliations
    Department of Neurology, Hospital Clinico San Carlos, San Carlos Institute for Health Research (IdiSSC), Universidad Complutense, Profesor Martin Lagos St. ES-28040, Madrid, Spain
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  • María Díez-Cirarda
    Affiliations
    Department of Neurology, Hospital Clinico San Carlos, San Carlos Institute for Health Research (IdiSSC), Universidad Complutense, Profesor Martin Lagos St. ES-28040, Madrid, Spain
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  • María Valles-Salgado
    Affiliations
    Department of Neurology, Hospital Clinico San Carlos, San Carlos Institute for Health Research (IdiSSC), Universidad Complutense, Profesor Martin Lagos St. ES-28040, Madrid, Spain
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  • Paloma Montero-Escribano
    Affiliations
    Department of Neurology, Hospital Clinico San Carlos, San Carlos Institute for Health Research (IdiSSC), Universidad Complutense, Profesor Martin Lagos St. ES-28040, Madrid, Spain
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  • Laura Hernández-Lorenzo
    Affiliations
    Department of Neurology, Hospital Clinico San Carlos, San Carlos Institute for Health Research (IdiSSC), Universidad Complutense, Profesor Martin Lagos St. ES-28040, Madrid, Spain

    Department of Computer Architecture and Automation, Faculty of Informatics, Universidad Complutense, Madrid, Spain
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  • Jorge Matías-Guiu
    Affiliations
    Department of Neurology, Hospital Clinico San Carlos, San Carlos Institute for Health Research (IdiSSC), Universidad Complutense, Profesor Martin Lagos St. ES-28040, Madrid, Spain
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  • Jordi A Matias-Guiu
    Correspondence
    Corresponding author.
    Affiliations
    Department of Neurology, Hospital Clinico San Carlos, San Carlos Institute for Health Research (IdiSSC), Universidad Complutense, Profesor Martin Lagos St. ES-28040, Madrid, Spain
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Published:August 05, 2022DOI:https://doi.org/10.1016/j.msard.2022.104091

      Highlights

      • Cross-Cultural Dementia (CCD) is a novel cognitive screening test.
      • We validated the CCD for cognitive impairment identification in MS.
      • CCD evaluates episodic memory, mental speed, and executive function.

      Abstract

      Background

      Several batteries have been developed for the cognitive assessment of people with multiple sclerosis (MS). However, all these tests have some limitations in general clinical practice and from a cross-cultural perspective. In this study, we aimed to validate a novel cognitive screening test, the Cross-Cultural Dementia screening test (CCD), in pwMS.

      Methods

      Seventy-five participants with relapsing-remitting MS and 75 healthy controls were enrolled and completed a comprehensive neuropsychological battery and the CCD. Intergroup comparisons, effect sizes, and correlations with previously validated tests were calculated for a majority and a pilot study of a minority sample. ROC curves were estimated, and random forest classification models were developed.

      Results

      There were statistically significant differences between cognitively impaired MS (MS-CI) group and healthy controls, and between MS-CI and non-cognitively impaired MS group in all subtests of CCD with medium to large effect sizes. Correlations with standardized neuropsychological tests were moderate to high, supporting concurrent validity. These results were replicated in the minority sample. The random forest models showed a very accurate classification using the CCD. This test showed good psychometric properties compared with SDMT.

      Conclusions

      Our study validates the CCD for cognitive impairment screening in MS, showing advantages over other routinely used cognitive tests.

      Keywords

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      References

        • Arango-Lasprilla J.C.
        • Rivera D.
        • Rodríguez G.
        • Garza M.T.
        • Galarza-Del-Angel J.
        • Rodriguez W.
        • Perrin P.B.
        Symbol digit modalities test: normative data for the Latin American Spanish speaking adult population.
        NeuroRehabilitation. 2015; 37: 625-638
        • Benedict R.H.
        • Amato M.P.
        • DeLuca J.
        • Geurts J.J.
        Cognitive impairment in multiple sclerosis: clinical management, MRI, and therapeutic avenues.
        Lancet Neurol. 2020; 19: 860-871
        • Benedict R.H.
        • Fischer J.S.
        • Archibald C.J.
        • Arnett P.A.
        • Beatty W.W.
        • Bobholz J.
        • Munschauer F.
        Minimal neuropsychological assessment of MS patients: a consensus approach.
        Clin. Neuropsychol. 2002; 16: 381-397
        • Cortés-Martínez A.
        • Matias-Guiu J.A.
        • Pytel V.
        • Montero P.
        • Moreno-Ramos T.
        • Matías-Guiu J.
        What is the meaning of PASAT rejection in multiple sclerosis?.
        Acta Neurol. Scand. 2019; 139: 559-562
        • Dagenais E.
        • Rouleau I.
        • Demers M.
        • Jobin C.
        • Roger É.
        • Chamelian L.
        • Duquette P.
        Value of the MoCA test as a screening instrument in multiple sclerosis.
        Can. J. Neurol. Sci. 2013; 40: 410-415
        • DeLong E.R.
        • DeLong D.M.
        • Clarke-Pearson D.L.
        Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach.
        Biometrics. 1988; : 837-845
        • Drake A.S.
        • Weinstock-Guttman B.
        • Morrow S.A.
        • Hojnacki D.
        • Munschauer F.E.
        • Benedict R.H.B.
        Psychometrics and normative data for the Multiple Sclerosis functional composite: replacing the PASAT with the symbol digit modalities test.
        Mult. Scler. J. 2010; 16: 228-237
        • Fisk J.D.
        • Pontefract A.
        • Ritvo P.G.
        • Archibald C.J.
        • Murray T.J.
        The impact of fatigue on patients with multiple sclerosis.
        Can. J. Neurol. Sci. 1994; 21: 9-14
        • Franzen S.
        Cross-cultural neuropsychological assessment in Europe: position statement of the European consortium on cross-cultural neuropsychology (ECCroN).
        Clin. Neuropsychol. 2021; : 1-12
        • Franzen S.
        • Papma J.M.
        • van den Berg E.
        • Nielsen T.R.
        Cross-cultural neuropsychological assessment in the European union: a delphi expert study.
        Arch. Clin. Neuropsychol. 2021; 36: 815-830
        • Franzen S.
        • van den Berg E.
        • Bossenbroek W.
        • Kranenburg J.
        • Scheffers E.A.
        • van Hout M.
        • Papma J.M.
        Neuropsychological assessment in the multicultural memory clinic: development and feasibility of the TULIPA battery.
        Clin. Neuropsychol. 2022; : 1-21
        • Genova H.M.
        • DeLuca J.
        • Chiaravalloti N.
        • Wylie G.
        The relationship between executive functioning, processing speed, and white matter integrity in multiple sclerosis.
        J. Clin. Exp. Neuropsychol. 2013; 35: 631-641
        • Gómez-Moreno S.M.
        • Cuadrado M.L.
        • Cruz-Orduña I.
        • Martínez-Acebes E.M.
        • Gordo-Mañas R.
        • Fernández-Pérez C.
        • García-Ramos R.
        Validation of the Spanish-language versión of the montreal cognitive assessment as a screening test for cognitive impairment in multiple sclerosis.
        Neurologia. 2020; (S0212-4853(19)30149-5)
        • Goudsmit M.
        • Uysal-Bozkir Ö.
        • Parlevliet J.L.
        • van Campen J.P.
        • de Rooij S.E.
        • Schmand B.
        The cross-cultural dementia screening (CCD): a new neuropsychological screening instrument for dementia in elderly immigrants.
        J. Clin. Exp. Neuropsychol. 2017; 39: 163-172
        • Healy B.C.
        • Barker L.
        • Bakshi R.
        • Benedict R.H.
        • Gonzalez C.T.
        • Chitnis T.
        • Glanz B.I.
        Trajectories of symbol digit modalities test performance in individuals with multiple sclerosis.
        Mult. Scler. J. 2021; 27: 593-602
        • Kalb R.
        • Beier M.
        • Benedict R.H.
        • Charvet L.
        • Costello K.
        • Feinstein A.
        • DeLuca J.
        Recommendations for cognitive screening and management in multiple sclerosis care.
        Mult. Scler. J. 2018; 24: 1665-1680
        • Krupp L.B.
        • LaRocca N.G.
        • Muir-Nash J.
        • Steinberg A.D.
        The fatigue severity scale: application to patients with multiple sclerosis and systemic lupus erythematosus.
        Arch. Neurol. 1989; 46: 1121-1123
        • Langdon D.W.
        • Amato M.P.
        • Boringa J.
        • Brochet B.
        • Foley F.
        • Fredrikson S.
        • Benedict R.H.B.
        Recommendations for a brief international cognitive assessment for multiple sclerosis (BICAMS).
        Mult. Scler. J. 2012; 18: 891-898
        • Macniven J.A.B.
        • Davis C.
        • Ho M.Y.
        • Bradshaw C.M.
        • Szabadi E.
        • Constantinescu C.S.
        Stroop performance in multiple sclerosis: information processing, selective attention, or executive functioning?.
        J. Int. Neuropsychol. Soc. 2008; 14: 805-814
        • Matías-Guiu J.A.
        • Cortés-Martínez A.
        • Montero P.
        • Pytel V.
        • Moreno-Ramos T.
        • Jorquera M.
        • Matías-Guiu J.
        Identification of cortical and subcortical correlates of cognitive performance in multiple sclerosis using voxel-based morphometry.
        Front. Neurol. 2018; : 920
        • Matias-Guiu J.A.
        • Cortés-Martínez A.
        • Valles-Salgado M.
        • Oreja-Guevara C.
        • Pytel V.
        • Montero P.
        • Matias-Guiu J.
        Functional components of cognitive impairment in multiple sclerosis: a cross-sectional investigation.
        Front. Neurol. 2017; 8: 643
        • Matías-Guiu J.A.
        • Sánchez-Benavides G.
        • Rivera-Àvila N.
        • Cortés-Martínez A.
        • Delgado- Alonso C.
        • Delgado-Álvarez A.
        • Peña-Casanova J.
        Validation of the neuronorma battery for neuropsychological assessment in multiple sclerosis.
        Mult. Scler. Relat. Disord. 2020; 42102070
        • Nielsen T.R.
        • Segers K.
        • Vanderaspoilden V.
        • Beinhoff U.
        • Minthon L.
        • Pissiota A.
        • Bekkhus-Wetterberg P.
        • Bjørkløf G.H.
        • Tsolaki M.
        • Gkioka M.
        • Waldemar G.
        Validation of a European Cross-Cultural Neuropsychological Test Battery (CNTB) for evaluation of dementia.
        Int. J. Geriatr. Psychiatry. 2019; 34: 144-152
        • Peña-Casanova J.
        • Blesa R.
        • Aguilar M.
        • Gramunt-Fombuena N.
        • Gómez-Ansón B.
        • Oliva R.
        • Sol J.M.
        Spanish multicenter normative studies (NEURONORMA project): methods and sample characteristics.
        Arch. Clin. Neuropsychol. 2009; 24: 307-319
        • Rao S.M.
        • Leo G.J.
        • Bernardin L.
        • Unverzagt F.
        Cognitive dysfunction in multiple sclerosis.: I. Frequency, patterns, and prediction.
        Neurology. 1991; 41: 685-691
        • Rao S.M.
        • Losinski G.
        • Mourany L.
        • Schindler D.
        • Mamone B.
        • Reece C.
        • Alberts J.
        Processing speed test: validation of a self-administered, iPad®-based tool for screening cognitive dysfunction in a clinic setting.
        Mult. Scler. J. 2017; 23: 1929-1937
        • Rosca E.C.
        • Simu M.
        Montreal cognitive assessment for evaluating cognitive impairment in multiple sclerosis: a systematic review.
        Acta Neurol. Belg. 2020; 120: 1307-1321
        • Ruet A.
        • Deloire M.S.
        • Charré-Morin J.
        • Hamel D.
        • Brochet B.
        A new computerized cognitive test for the detection of information processing speed impairment in multiple sclerosis.
        Mult. Scler. J. 2013; 19: 1665-1672
        • Ryan J.
        • Woods R.L.
        • Britt C.J.
        • Murray A.M.
        • Shah R.C.
        • Reid C.M.
        • Storey E.
        Normative data for the symbol digit modalities test in Older White Australians and Americans, African-Americans, and Hispanic/Latinos.
        J. Alzheimer's Dis. Rep. 2020; 4: 313-323
        • Sandry J.
        • Simonet D.V.
        • Brandstadter R.
        • Krieger S.
        • Sand I.K.
        • Graney R.A.
        • Sumowski J.F.
        The symbol digit modalities test (SDMT) is sensitive but non-specific in MS: lexical access speed, memory, and information processing speed independently contribute to SDMT performance.
        Mult. Scler. Relat. Disord. 2021; 51102950
        • Sanz J.
        • Perdigón A.L.
        • Vázquez C.
        Adaptación española del Inventario para la Depresión de Beck-II (BDI-II): 2. Propiedades psicométricas en población general.
        Clín. Salud. 2003; 14: 249-280
        • Thompson A.J.
        • Banwell B.L.
        • Barkhof F.
        • Carroll W.M.
        • Coetzee T.
        • Comi G.
        • Cohen J.A.
        Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria.
        Lancet Neurol. 2018; 17: 162-173